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Psychiatry Block 2010-2011. Steven W. Clay, DO Associate Professor, Family Medicine, OUCOM. Three Modules. 1. Mood, Addiction and Childhood Disorders 2. Anxiety, Somatoform, Sexual, Eating Disorders 3. Psychotic, Delusional and Personality Disorders. Major Changes from 2009-2010.
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Psychiatry Block 2010-2011 Steven W. Clay, DO Associate Professor, Family Medicine, OUCOM
Three Modules • 1. Mood, Addiction and Childhood Disorders • 2. Anxiety, Somatoform, Sexual, Eating Disorders • 3. Psychotic, Delusional and Personality Disorders
Major Changes from 2009-2010 • Neurophysiology is not well tested by NBME. • Thus 15 quiz questions were made to cover this material. • These were given during the S&I session at the end of the block. • Some mix up in preparation of quizes • Not well received by students
Psych texts • Kaplan and Sadock's Concise Textbook of Clinical Psychiatry (2008) • Seldom used by students • First Aid for the Psychiatry Clerkship: Second Edition 2005 • Most students used this psychiatry rotation review.
Lectures • Child and adolescent disorders were to be taught in person by Dr. Austerman as in the previous year. • Unfortunately he cancelled two weeks before the block. Coon, Correll (Dayton), and Bianco covered • Continued from last year: • Disorders secondary to a general medical condition (endocrine, neuro, etc)
Case vignettes (problem sets) • Clinical vignettes to foster discussion of the diagnosis, treatment, etc of the disorders. were incorporated into lectures rather than having separate scheduled time slots. • The day before the exam a review session of 50 case vignettes to foster discussion of the diagnosis, treatment, etc of ALL of the disorders.
NBME Exam • Generally Given upon Completion of a Psychiatry Rotation • Some Material Students Have Not Yet Studied: • Addiction, Endocrine and Metabolism • Does not cover neurophysiology provided in the block • Very, very difficult compared to previous
NBME Exam Scoring • NBME • Utilized Angoff and Hofstee methods • Compared to some 2693 Examinees across the country • Passing 65% • Honors 84%
Our students • Mean 64.4 • SD 7.4 • High score 85 • Low score 45
Our students • 46 passed (last year 60%) • 1 passed with honors (last yr 4) • 48 failed • 15 points added to pull top student to 100% • After quiz score adjustment six students for block reassessment
Student Feedback • The medical knowledge learning topics helped to direct my learning 2007 2008 2009 2010 4.4 2.3 4.2 4.5 • The sequence of learning activities enhanced my learning 2007 2008 2009 2010 4.9 3.4 4.5 4.6
Student Feedback • The labs enhanced my learning 2007 2008 2009 2010 4.6 3.6 4.6 4.7 • The overview lectures provided me with a global perspective on the topic 2007 2008 2009 2010 4.9 3.8 4.5 4.7
Student Feedback • The focused lectures enhanced my understanding of difficult topics 2007 2008 2009 2010 5.0 3.6 4.4 4.4 • The problem sets enhanced my ability to apply the concepts I learned 2007 2008 2009 2010 4.5 3.2 4.6 4.8
Student Feedback • The self assessment quizzes helped my learning & my exam preparation 2007 2008 2009 2010 4.2 2.9 4.4 4.4 • S&I helped me synthesize & apply medical knowledge to clinical situations 2007 2008 2009 2010 4.7 3.0 4.4 4.3
Student Feedback • S&I quizzes - opportunity to demonstrate my clinical reasoning skills 2007 2008 2009 2010 4.7 3.3 4.5 4.3 • The written exam was representative of the block’s learning topics 2007 2008 2009 2010 4.1 2.1 3.8 3.7
Student Feedback • The written block exam measured my mastery of the objectives 2007 2008 2009 2010 4.4 2.3 4.2 3.6 • Overall I rate this Block as excellent 2007 2008 2009 2010 4.0 2.1 3.9 3.6 • Average overall 2007 2008 2009 2010 4.5 3.0 4.3 3.8
Problems • Last year’s students said the lectures did not cover what was on the exam • Thus many students did not attend lectures – as few as 12 attending • Most students did NOT read the Sadock Concise Textbook of Clinical Psychiatry • Many students used the First Aid for the Psychiatry Clerkship
Problems • Most students did not like the NBME shelf exam feeling it was too advanced for them • Neuropsycology presented in lectures was tested by the end of block quiz which had mistakes in the printed form • Students felt the NBME exam may have detracted from interest in the block • Several students felt there was not enough time for the exam
Possible Solutions • Add specific psychopharmacology lectures • More stress on medical conditions producing psychiatric problems • Best solution: Move Psych Block to later in the year
Conclusions • The Psychiatry Block is still comprehensive and of high quality but students may not have recognized it as such • Problem sets were helpful • Student evaluations are lower likely due to an unusually difficult exam this year • Lectures were poorly attended • Moving the Psychiatry Block to later in the year will be helpful